INSTRUCTIONS
FO
R
STATEMENT OF CHANGE OF REGISTERED OFFICE AND/OR REGISTERED A
GE
N
T
All Business Entities must submit a Statement of Change form to change the Registered Office and/or
Registered Agent in Iowa.
It is important to read these INSTRUCTIONS before you fill out the Change form. The numbers on these
instructions correspond to the numbering on the form. PLEASE PRINT LEGIBLY.
1.
Print the full name of the Business Entity. Several types of Business Entities use this same
form, so include the suffix and proper punctuation.
2.
Print the street address, city, state and zip code of the CURRENT Registered Office.
3.
Print the street address, city, state and zip code of the NEW Registered Office.
4.
Print the full name of the CURRENT Registered Agent.
5.
Print the full name and email address of the NEW Registered Agent.
The NEW Registered Agent, if any, must sign, consenting to their appointment, or attach a
separate written consent to this form.
If the Registered Agent changes the street address of their business office, they must NOTIFY the
business entity and sign, indicating that NOTICE has been given.
Requires no information. However, it is a required statement, and should be used as a check to
verify that, after changes, the street address of the registered office and the street address of the
business office of the registered agent are the same.
Statement of Change form should be signed as follows. It must also state the date signed, the person’s
name, and the capacity in which the person signed.
Profit, Nonprofit, and Professional Corporations:* - No fee required.
By the chairperson of the board of directors, the president, or another officer of the corporation.
Limited Liability Companies:* - No fee required.
c.
Partnerships:* - $5.00 fee required.
By two or more partners, a person authorized under Iowa Code ch. 486A, or other law.
Cooperative Associations
497,
498 and 499:* - No fee required.
By the association’s presiding officer of the board of directors, or the president or other officer.
Cooperative Corporations (501) and Cooperative Associations (501A): - No fee required.
By one of the cooperative’s officers.
* If the Business Entity is in the hands of a receiver, trustee, or other court-appointed fiduciary, by that fiduciary.
NOTES:
1. One copy is to be delivered or faxed to the Secretary of State for filing.
2. The information you
provide will be open to public inspection under Iowa Code chapter 22.11.
SECRETARY OF
STATE
Business Services
Division
Lucas Building, 1st
Floor
Des Moines, Iowa
50319
Phone: (515)
281-5204
Fax: (515)
242-5953
635_0119
rev. 1/15
Website: sos.iowa.gov
